Non-Ablative Brain Surgery Treats Neurological Diseases – Surgical Techniques


Image: The ExAblate Focused Ultrasound System (Photo courtesy of InSightec)

Low-intensity MRI-guided focused ultrasound (MRgFUS), combined with intravenous microbubbles, may help deliver targeted neurotoxin therapy, research shows.

The new technique, called PING, was developed by researchers at the University of Virginia (UVA; Charlottesville, USA), Stanford University (CA, USA) and other institutions. It is designed to destroy neurons in the brain parenchyma by opening the blood-brain barrier (BBB) ​​transiently and focal to deliver a systemically administered neurotoxin (quinolinic acid) that is well tolerated peripherally and otherwise impermeable to BBB . .

In two research models of epilepsy in rats, researchers found that PING can reduce or eliminate seizures. Focal neuronal loss has been observed in targeted areas of the BBB opening, including brain regions that are the primary targets of epilepsy surgery. Notably, they found that other structures in the area of ​​neuronal loss, including passing axons, glial cells, the vasculature, and the ventricular wall, were spared by this procedure. The study was published on November 19, 2021 in the Journal of Neurosurgery.

“This new surgical strategy has the potential to supplant existing neurosurgical procedures used for the treatment of neurological disorders that are unresponsive to drugs. This unique approach eliminates diseased brain cells, spares adjacent healthy cells and achieves these results without even having to cut the scalp, ”said lead author Kevin Lee, PhD, Departments of Neuroscience and Neurosurgery at UVA and the Center for Brain Immunology. and Glia (BIG). “Our hope is that the PING strategy becomes a key component of the next generation of very precise and non-invasive neurosurgical approaches to treat major neurological disorders. “

BBB is made up of specialized endothelial cells that form the capillary microvasculature of the central nervous system (CNS) and is essential for the functioning of the brain. It selectively blocks substances from entering the blood and brain, allowing only essential molecules such as amino acids, oxygen, glucose and water to pass through. But on the other hand, it is also the biggest obstacle to the treatment of many CNS diseases, as it usually blocks the entry of therapeutic compounds.

Related links:
University of Virginia
Stanford University

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